Peripheral Arterial Disease

Question 1

What does ulceration and gangrene indicate in peripheral arterial disease?

Answer 1

It is critical limb ischaemia

Question 2

What are the main signs of peripheral arterial disease?

Answer 2

Absent femoral, popliteal or foot pulses
Cold, white legs
Painful ulcers
Capillary filling time >15s

Question 3

How is Ankle Brachial pressure index calculated?

Answer 3

Ankle pressure divided by Brachial pressure

Question 4

What figure from the ankle brachial pressure index indiates peripheral arterial disease?

Answer 4

0.5-0.9

Question 5

If ABPI is lower than 0.5, what does that indicate?

Answer 5

Critical Limb Ischaemia

Question 6

What are the two main outcomes hoped for in management of PAD?

Answer 6

Secondary Prevention

Symptom Improvement

Question 7

What are the treatment options in secondary prevention of PAD?

Answer 7

Anti-platelet
Statins
Diabetes screening
Smoking cessation
Tight BP control
ACEI

Question 8

What are the treatment options for symptom improvement of PAD?

Answer 8

Pharmacotherapy
Exercise therapy
Angioplasty
Surgery

Question 9

What is the main advantage of angioplasty over surgery?

Answer 9

Reduced morbidity

Question 10

Which treatment option for PAD is more durable, surgery or angioplasty?

Answer 10

Surgery

Question 11

What is the main post-surgical complication in PAD?

Answer 11

Myocardial Infarction

Question 12

What are the two main causes of acute limb ischaemia?

Answer 12

In situ thrombosis

Embolus

Question 13

What are the 6P’s of acute ischaemia?

Answer 13

Pale
Pulseless
Painful
Paralysed
Parasthetic
Perishingly cold